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The mean age at diagnosis was 63 years (range, 19 to 93 y; median 63 y).

Clinical symptoms varied with the most common manifestations, including gross hematuria, bladder/urethral stones, history of prostate cancer treated with radiation, follow-up after bladder/ureter carcinoma treatment, long-term urinary stents, and colovesicular fistulas.

In cases where the diagnosis of papillary neoplasia is not straightforward and there is a question of polypoid cystitis, pathologists should seek clinical history that might suggest a reactive process.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] No mutations of FGFR3 in normal urothelium in the vicinity of urothelial carcinoma of the bladder harbouring activating FGFR3 mutations in patients with bladder cancer.

Mutations in the fibroblast growth factor receptor 3 (FGFR3) gene causing constitutive oncogenic protein activation have been shown to be frequent in papillary noninvasive bladder tumours and are associated with a low risk of progression and a favourable outcome.

FGFR3 alterations have also been found in benign urothelial papilloma and flat urothelial hyperplasia suggesting FGFR3 alterations as an early event in bladder tumorigenesis.

To date there is no data available on FGFR3 mutations in normal urothelium from patients with bladder cancer.

We therefore analysed 64 samples of histopathological unsuspicious normal urothelium from 38 patients with FGFR3 mutated bladder tumours and 15 samples of urothelium from patients (n = 15) without any urothelial malignancy as a control group.

FGFR3 analyses did not reveal any mutation in the urothelium from neither the control group nor the bladder cancer group.

These data suggest that mutations in the FGFR3 gene are not the earliest genetic alterations in bladder carcinogenesis and are associated with a hyperproliferative (hyperplastic) phenotype in the urothelium.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Urothelial neoplasia of the urinary bladder--comparison of interobserver variability for WHO Classification 1972 with WHO/ISUP Consensus Classification 1998.

BACKGROUND: Classification of urothelial bladder tumours is an important factor in the treatment and prognosis of these lesions.

The objective of this study was to classify urothelial neoplasms of the urinary bladder using the latest WHO/ISUP Consensus Classification 1998 and WHO Classification 1972 and compare the two regarding interobserver variability.

METHODS: This study included 100 consecutive biopsy specimens of urothelial neoplasms of the urinary bladder diagnosed at the department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

However, the papillary fronds were similar to those of exophytic urothelial papilloma.

The recognition of papillary structures in urothelial inverted papilloma broadens the morphological spectrum of this unusual benign urothelial neoplasm and complicates the microscopic interpretation of urothelial lesions with inverted growth patterns.

Surgical pathologists should be aware of this unusual feature of inverted urothelial papilloma of the urinary bladder to avoid misinterpretation with urothelial carcinoma with an inverted pattern.

Within the spectrum of findings in inverted papilloma, vacuolization and foamy (xanthomatous-appearing) cytoplasmic changes have not been previously reported.

In the current study, we present 5 novel cases of inverted papilloma involving 2 men and 3 women ranging in age from 48 to 88 years, who presented with microhematuria (n = 3) or irritative symptoms (n = 2).

Cystoscopically, the lesions were polypoid (n = 3), pedunculated (n = 1), or solid (n = 1), measured between 0.7 and 2.5 cm, and were all located at the trigone or bladder neck.

Morphologically, all cases had some component of usual inverted papilloma along with areas displaying foamy or vacuolated cytoplasm encompassing 30% to 90% of the lesion.

These "clear cells" were seen both in distinct regions within the biopsy and, more frequently, intermingled with usual inverted papilloma cells.

The diagnostic dilemma encountered in these cases of inverted papilloma with foamy or vacuolated cytoplasm warrants their distinction from other benign and malignant urothelial lesions with inverted growth and/or clear cell features.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] [Inverted papilloma of the bladder: diagnosis and course].

OBJECTIVE: To analyse the diagnosis, treatment and clinical course of inverted papilloma of the bladder MATERIALS AND METHODS: Between January 1980 and January 2004, 12 patients with an inverted papilloma of the bladder were included, representing 0.36% of all bladder tumours treated over the same period.

The most frequent presenting complaint was macroscopic haematuria (10/12 cases), associated with signs of bladder irritation in 8 cases.

CONCLUSION: Inverted papillomas of the bladder are rare, benign tumours that can be associated with urothelial carcinoma, requiring rigorous surveillance.

No patients had a prior history of either inverted papilloma or urothelial carcinoma, whereas 2 patients were diagnosed with high-grade urothelial carcinoma of the bladder synchronous with their inverted papillomadiagnosis.

Only 1 of the 18 patients with available follow-up had a recurrence of inverted papilloma in the prostatic urethra.

Inverted papillomas of the prostatic urethra are benign lesions that are commonly detected incidentally and are not associated with a history of urothelial malignancy.

Although urothelial carcinoma elsewhere in the genitourinary tract may occur simultaneously, malignant transformation or recurrence as a malignant lesion has not been identified in inverted papilloma of the prostatic urethra.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

Surprisingly, identical somatic activating mutations have been found at the somatic level in tumours: at high frequency in benign epithelial tumours (seborrheic keratosis, urothelial papilloma) and in low-grade, low-stage urothelial carcinomas, and at a lower frequency in other types of urothelial carcinoma, in cervix carcinoma, and in haematological cancer, multiple myeloma.

Although mutated FGFR3b is mostly found in benign epithelial tumours or carcinomas of low malignant potential, we present evidence here that mutated FGFR3b is oncogenic.

NIH-3T3 cells transfected with a mutated form of FGFR3b--FGFR3b-S249C, the most common mutation in bladder tumours--presented a spindle-cell morphology, grew in soft agar and gave rise to tumours when xenografted into nude mice.

We identified one line of 17 bladder cell lines tested (MGH-U3) that expressed a mutated form of FGFR3b, FGFR3b-Y375C.

This article summarizes the recent literature concerning important issues in the pathology and the clinical management of patients with bladder urothelial carcinoma.

Emphasis is placed on clinical presentation, the significance of haematuria, macroscopic appearance (papillary, solid or mixed, single or multiple) and synchronous or metachronous presentation (field disease vs monoclonal disease with seeding), classification and microscopic variations of bladder cancer with clinical significance, TNM distribution and the pathological grading according to the 2004 WHO proposal.

CONCLUSION: Most Wilms tumors in children with WT1-related disorders were early-stage and intermediate-risk tumors, with a young age at diagnosis.

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(PMID = 18816692.001).

[ISSN] 1545-5017

[Journal-full-title] Pediatric blood & cancer

[ISO-abbreviation] Pediatr Blood Cancer

[Language] eng

[Publication-type] Journal Article

[Publication-country] United States

18. Thomas G, Gera P, Arbuckle S, Cohen R: Transitional cell papilloma of the bladder in a child: a case report and review of literature.J Pediatr Urol; 2006 Feb;2(1):59-62[Fulltext service] Get downloadable fulltext PDFs of articles closely matching to this article, as many as you want.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Transitional cell papilloma of the bladder in a child: a case report and review of literature.

Transitional cell papillomas of the bladder are tumours of epithelial origin that are extremely rare in children.

They are benign and endoscopic excision has been considered curative; however, the rate of recurrence reported in the literature is fairly high, with the earliest recurrence being at 3 months.

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[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

Because diseases influence the expression of uroplakins, the main urothelial differentiation-related proteins, we compared their expression and localization with that of inducible NOS (iNOS) in bladder outlet obstruction caused by benign prostatic hyperplasia and in noninvasive urothelial neoplasms (papilloma, low-grade, and high-grade papillary carcinoma).

These results suggest that various urinary bladder lesions alter the normal differentiation pathway of urothelial superficial cells, which induces the expression of NOS in mitochondria of partially differentiated cells.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Natural history of urothelial inverted papilloma.

Although it is traditionally regarded as a benign tumor, conflicting data on multiplicity, recurrence rate, and association with urothelial carcinoma have left uncertainties concerning its biologic behavior.

METHODS: The authors analyzed the clinicopathological characteristics of 75 cases of inverted papilloma in the urinary tract without prior or concurrent urothelial carcinoma to determine its biologic behavior and prognosis, and to correlate these findings with surveillance strategies.

The majority of vesical tumors arose from the trigone or near the bladder neck.

In 1 case of vesical inverted papilloma, there was a recurrence.

CONCLUSIONS: Both the extremely low incidence of tumor recurrence (1%) and strikingly favorable prognosis suggest that inverted urothelial papilloma, when diagnosed according to strictly defined criteria, is a benign urothelial neoplasm not related to urothelial carcinoma.

Therefore, complete transurethral resection of inverted papilloma is adequate surgical therapy, and surveillance protocols as rigorous as those employed in the management of urothelial carcinoma seem unnecessary.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Human papillomavirus and p16 expression in inverted papillomas of the urinary bladder.

Human Papillomaviruses (HPVs) have been found in association with benign and malignant growth of epithelia.

Inverted papillomas of the urinary bladder are epithelial tumors considered to be of benign nature.

In this report we analyze the expression of p16(Ink4a) and the presence of HPV sequences in inverted papillomas and in non-tumoral bladder controls.

We conclude that HPV does not play an indispensable role in the development of urinary bladder inverted papillomas and that overexpression of p16(Ink4a) does not correlate with HPV infection in these tumors.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

Inverted papilloma of urinary bladder is an uncommon urothelial neoplasm.

Little is known of the genetic abnormalities of inverted papilloma.

The monoclonal origin demonstrated in the study of X-chromosome inactivation indicates the clonal process of inverted papilloma; however, the low incidence of LOH supports the view that inverted papilloma in urinary bladder is a benign neoplasm with molecular genetic abnormalities different from those of urothelial carcinoma.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

Benign gallbladder adenomas occurred at low incidences in male mice at 20 and 40 mg/kg (area under the curve [AUC] exposures > or = 62 times human exposure at 5 mg/day) and were considered drug related due to an increased incidence of gallbladder mucosal hyperplasia at these doses.

There was a dose-related increased incidence of transitional cell papilloma and carcinoma of the urinary bladder in male rats at 5, 30, and 50 mg/kg (AUC exposures > or = 8 times human exposure at 5 mg/day).

At 30 and 50 mg/kg, the urinary bladder tumors were accompanied by evidence of increased urine solids.

Subsequent investigative studies established that the urinary bladder carcinogenic effect was mediated by urolithiasis rather than a direct pharmacologic effect on urothelium.

Considering that muraglitazar is nongenotoxic, the observed tumorigenic effects in mice and rats have no established clinical relevance since they occurred at either clinically nonrelevant exposures (gallbladder and adipose tumors) or by a species-specific mechanism (urinary bladder tumors).

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] [Can inverted papilloma in urinary bladder be considered as a benign tumor].

Inverted papilloma of the urinary bladder is a rare entity.

They aimed to find out the rate of inverted papilloma recurrences, and transformations into malignant bladder cancer.

MATERIALS AND METHODS: Thirty patients with histologically proven inverted papilloma were followed after transurethral resection of bladder, which meant urine tests every three months, abdominal ultrasound and cystoscopy.

In one case, inverted papilloma and transitiocellular tumor (pTa G1) were detected.

In one patient, inverted papilloma was found by control cystoscopy after transurethral resection of bladder (pT1 G2) and local chemotherapy 15 months later.

CONCLUSIONS: Based on authors' experience, inverted papilloma of the urinary bladder is a benign lesion, but malignant changes or concomitant transitiocellular tumor may occur, thus follow-up is needed.

Although references are not standardized, authors suggest following patients with inverted papilloma as a primary (pTa G1) bladder cancer.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

Due to the cells' deceptively bland appearance, the tumors are sometimes misdiagnosed as benign lesions, leading in some cases to a significant delay in establishing the correct diagnosis and thus contributing to this neoplasm's advanced stage.

Nested variant of urothelial carcinoma must be differentiated from the benign proliferative lesions of urothelium, such as von Brunn nests, cystitis cystica, cystitis glandularis, nephrogenic adenoma, inverted papilloma, and paraganglioma.

Thus, in histologically proven solitary bladder IP with no associated TCC, cystoscopic surveillance may not be necessary.

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(PMID = 16904447.001).

[ISSN] 1527-9995

[Journal-full-title] Urology

[ISO-abbreviation] Urology

[Language] eng

[Publication-type] Journal Article

[Publication-country] United States

32. van der Kwast TH: How to combine the molecular profile with the clinicopathological profile of urothelial neoplastic lesions.Scand J Urol Nephrol Suppl; 2008 Sep;(218):175-84[Fulltext service] Get downloadable fulltext PDFs of articles closely matching to this article, as many as you want.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

Regarding urothelial papilloma, clinical and limited molecular-genetic data seem to suggest that they may not represent a precursor lesion for bladder cancer.

It is more likely that urothelial papilloma is a benign neoplasm sharing mutations in the fibroblast growth factor-3 gene with seborrhoeic keratosis, allegedly its epidermal counterpart.